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Postman医生问:偶有人在秋季接种1剂流感疫苗后3或4个月要求接种第2剂疫苗.是否需要接种“双剂”流感疫苗?此免疫方案可能发生哪些不良反应?Nichol医生(明尼苏达大学医学院)答:目前对流感疫苗应用的建议重点是每年1次接种流感并发症高危人群和把流感传播给高危人群的危险性增高者.对成人的推荐方案是单剂肌肉注射.仅对从未接种过疫苗的9岁以下儿童建议接种第2剂疫苗.健康成人于接种疫苗后2周内产生抗体,4～6周抗体水平达到高峰.对健康成人的研究显示提示,首剂接种后1个月给予第2剂疫苗不能明显增强接种者对疫苗的抗体应答和增加具有保护性抗体水平的人数.确有少数资料提示,接种第2剂疫苗可增加抗体滴度升高4倍的免疫损害患者人数.在接受化疗的淋巴瘤患者中对两剂免疫方案的评估研究显示,大多数仅在第2剂接种后抗体滴度升高4倍的患者在第1次接种前已有高抗体水平.
Dr. Postman asks: Sometimes a second dose of vaccine is required 3 or 4 months after an influenza vaccine is given in the fall. Are “two-dose” flu vaccines required? What are the possible side effects of this immunization regimen? Dr. Nichol (University of Minnesota Medical School) A: The current focus of the recommendations for the use of influenza vaccines is on a yearly basis to vaccinate at-risk populations of influenza and to increase the risk of the spread of influenza to high-risk populations. The recommended regimen for adults is single-dose intramuscular injection, Vaccination with a second dose of vaccine is recommended for children under the age of 9 who have not been vaccinated.A healthy adult develops antibodies within 2 weeks of vaccination and has a peak antibody level from 4 to 6 weeks.Studies on healthy adults suggest that the first dose after inoculation 1 A monthly dose of the second vaccine did not significantly enhance the vaccine’s antibody response to the vaccinee and increased the number of patients with protective antibodies.3 There is a paucity of data suggesting that vaccination with the second vaccine increased immune damage by a factor of 4 Patient Number Studies evaluating two-dose immunization protocols in patients undergoing chemotherapy with lymphoma showed that most patients with a 4-fold increase in antibody titer only after the second dose were vaccinated Have a high antibody level before vaccination.